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DocuSign Envelope ID: 7796CD94- 342E- 40D0- B7C3- A2B604F926B4 <br />ORANGE COUNTY <br />Maime of Contractor, Vendor or &rider. <br />Department of Solid Waste Management <br />As of the date listed below, the contractor, vendor or bidder listed above, and all subcontractors <br />utilized by the contractor, vendor or bidder listed above, is not listed oil the Final Divestment List <br />cmated by the State Treasurer ptni:uantto N,C.G.S. 143 - 6p,. -4. <br />The undersigned hereby certifies that he or she is authorized by tine contractor, vendor or bidder <br />listed above to make the foregoing statement. <br />o 6 f-c)4-� <br />,. 'e c(,e- <br />nted Naml Title <br />Notes topersorts vignitig this fvron: <br />N.(C.G.S. 1430- M -5(a) requires this ccttiticatiDn tiff bids or contracts with the State of North <br />Carolina, a North Carolina local govcranicnt, or any other political subdivision of the State of Nordi <br />Carolina. The certification is aetiu.ired tit the following titnes. <br />O When it bid is submitted <br />Q When a contract is entered into (if the i- Trtifcation wits not already inude when the vendor <br />made its bid) <br />0 When a contract is renewed or assiVied <br />N.C.G.S, 143C-6A -5(b) regiiirvs that coatnictors with the State, a North Carolina local government, <br />or any otlx:r lxilitical subdivision of the State of North Carolina must not utilize any subcontractor <br />found on the Slate TSeasuter's Final Divesttnenl list. The State Treasurer's final DivestnimiI Mist <br />can be fatmd on the State Trea,Starer's website at the address s v%-v ictr•asur o •.cojii /lratn and will be <br />updated every 180 day& <br />* "*'-'Contractor, Vendor or Bidder - Return This Form With All Other Required Docurnentation "*x'* <br />24 <br />Ri_R No. 5427 <br />